Kornimate/medical-research-clean huggingface dataset:
the application of 3t mri in esophageal cancer

Conditions: Esophageal Cancer TNM Staging; Magnetic Resonance Imaging; Prognosis

Summary: it is very significant that assessing tn staging in esophageal cancer patients before surgery, furthermore, determining the optimize surgical strategy, predict the the efficacy of radiotherapy for patients who were not chosen to be surgeried, and define the range of lymph node for radiotherapy. it has been reported that the application of mri in metastasis of lymph node of other cancer, but not in metastasis lymph node with esophageal cancer. only a few studies focused on t staging using conventional mri in esophageal cancer, however, relatively new sequences in the chest deserve widely used. to develop a pre-treatment evaluation methods for tn staging in patient with esophageal cancer by utilization of the new imaging methods (t2-tse-blade, t2 maps, starvibe). by analysising the relationship between tn staging and imaging features to find the imaging characteristics for tn staging, and to find the indicators of magnetic resonance imaging new technology and reference values for facilitate pre-treatment diagnosis of lymphnode metastasis, optimize surgical strategy, predict the the efficacy of adjunctive therapy, and os and define the range of lymph node for radiotherapy, as making personal treatment planning for esophageal cancer.

to explore the value of 3 t mri using multiple sequences, including t2-tse-blade, t2 maps and starvibe, in evaluating the preoperative tn staging and prediction of response to neoadjuvant therapy and os in patients with esophageal cancer. patients with endoscopically biopsy-proven ec were prospectively enrolled for imaging on a 3 t scanner. the mri protocol included t2-tse-blade, t2 maps and starvibe sequences, and so on. patients received treatment according to nccn guideline. readers assigned a tn stage on mri, and post-operative pathologic confirmation was considered the gold standard. inter-reader agreement, the diagnostic accuracy of tn staging on mri were analyzed and compared to post-operative pathologic tn staging. mri features were analyzed to find the correlation between pretreatment mri features and response or os. the study will includ 400 patients. inter-reader agreements of tn staging were analyzed excellent for mri. diagnostic accuracy of mri will be calculated.

Eligibility criteria:
inclusion criteria: 1. consecutive patients with preoperative pathologically con-firmed ec by endoscopy and preoperative imaging data (esophagography\\ct\\eus\\mri) were included. 2. no contraindications for mri examination. 3. the patients participate in this study with informed consent. exclusion criteria: 1. the patients couldn't performed mr scanning or artefacts affect the evaluation. 2. thepatients are extremely anxious and uncooperative about surgery or neoadjuvant therapy. 3. patientsthe patients refuse to participate in the project.

Keywords: esophageal cancer magnetic resonance imaging prognosis neoplasm staging
study of new ric regimen of buflu in older and/or intolerable patients

Conditions: Leukemia; Myelodysplastic Syndrome

Summary: the purpose of this study is to determine whether the new ric regimen, containing of low dose of bu (9.6mg/kg)and fludarabine without atg, is suitable and effective in treating aged and/or intolerable patients with hematologic malignant disease, who undergoes allogenic stem cell transplantation.


Eligibility criteria:
inclusion criteria: * diagnosed of hematologic malignant disease * will undergo hla matced hsct * age \>=55years * \<55year and intolerable to standard myeloablative conditioning exclusion criteria: * kps status \<70 * cardiac ef\<50% * creatine clearance \<50 ml/min * alt more than 10 times of upper normal limit

Keywords: hematopoietic stem cell transplantation busulfan fludarabine
role of msct volumetry in assessment of brain atrophy in septic patients

Conditions: Sepsis-Associated Encephalopathy

Summary: assessment of brain atrophy associated with septic icu patients by using msct volumetry

sepsis is the leading cause of admission to icu , the number of patients who survive and discharge from icu has also increased due to technological advances in icu however quality of life of these patients after icu discharge is lower than that of healthy people of a similar age, in particular sepsis associated encephalopathy associated with brain dysfunction. we hypothesized that brain damage including brain volume reduction that ocurre in acute phase of sepsis using ct scan and there finding " relationship to risk factor and outcome". we compared head ct finding at time of admission with those obtained during the course of the treatment

Eligibility criteria:
inclusion criteria: * patients \>16years old with sepsis associated with disturbance in conscious level admitted to icu exclusion criteria: * age\< 16y brain death hematological disease malignant disease hypoxemia error in automatic tissue classification motion artifac
cost-effectiveness of pci with taxus vs cabg - 5 years fup

Conditions: Multivessel Coronary Artery Disease

Summary: the objective of the present study is to analyze the cost-effectiveness of percutaneous coronary intervention (pci) using taxus stents compared to the costs of coronary artery bypass surgery (cabg) in patients with multivessel coronary artery disease (cad) in the first 5 years and then 10 years after intervention. multivessel pci or cabg was performed in 114 or 93 patients, respectively. clinical outcomes, in terms of incidence of acute myocardial infarction (ami), all-cause death, target vessel revascularization (tvr) and stroke, resource use and costs are analyzed prospectively over a 5 and 10-year follow-up (fup) period. overall costs consist of the baseline costs of the index procedure (pci or cabg), clinical and angiographic procedure-related treatments during the entire fup. the primary endpoint is cost-effectiveness and clinical effectiveness, defined as the reduction of the composite of major adverse cardiac and cerebrovascular events (macce).


Eligibility criteria:
inclusion criteria: * two or three-vessel disease requiring percutaneous or surgical multivessel intervention with the aim of complete revascularization * age \> 18 years * clinical symptoms (stable or unstable angina) or signs of myocardial ischemia * ≥ 50% diameter stenosis of each lesion exclusion criteria: * acute myocardial infarction (\< 48 h); * contraindications to clopidogrel, aspirin, heparin and taxol; * pregnancy or lack of protection against pregnancy or breast-feeding during the study; * hemorrhagic diathesis and platelet count \<100.000/ml3

Keywords: multivessel coronary artery disease drug-eluting stent cabg cost-effectiveness
prognostic factor analysis in metastatic esophageal squamous cell carcinoma

Conditions: Metastatic Esophageal Squamous Cell Carcinoma

Summary: esophageal squamous cell carcinoma is considerably more prevalent in east asia. despite of relatively high prevalence of esophageal scc, prognosis is very poor with limited options of effective chemotherapy regimens. we attempted to identify favorable subgroups of patient who are likely to benefit from 5- fluorouracil/cisplatin(fp) or capecitabine/cisplatin (xp) chemotherapy as first-line treatment.between january 2000 to december 2010, 239 patients were diagnosed of recurrent, metastatic esophageal scc and received either fp or xp as first-line chemotherapy. clinicopathologic variables and treatment outcome were retrospectively collected. we analysis treatment outcome of palliative chemotherapy in metastatic esophageal squamous cell carcinoma and make prognostic scoring system. the present study represents the largest series to analyze the treatment outcome of fp/xp chemotherapy in metastatic scc. risk-adapted stratification of treatment for subgroup of metastatic scc patients should be actively pursued.


Eligibility criteria:
inclusion criteria: * recurrent, metastatic esophageal scc * received either fp or xp as first-line chemotherapy. exclusion criteria:

Keywords: metastatic esophageal squamous cell carcinoma fluoropyrimidine/platinum-based first-line chemotherapy prognosis
compression device safety study on edema

Conditions: Edema

Summary: to evaluate the safety of the prototype compression device in subjects with oedema


Eligibility criteria:
inclusion criteria: * subjects aged between 18 and 80, willing and able to provide written informed consent, and able to wear the device and follow the requirements of the protocol * subjects who have an ankle to brachial pressure index (abpi) of at least 0.8. * subjects who suffer from chronic oedema (i.e. ceap classification of c3, c4 or c5 1.) * subjects who have chronic venous insufficiency (cvi), which has been present for 6 weeks or longer and who have refluxes \>0.5 sec in one or more major venous segments, superficial or deep or both (ceap classification: c3-c5 1.; ep,s; as,d; pr). exclusion criteria: * subjects with a history of skin sensitivity to any of the components of the study product. * subjects who have previously been entered into the study before * subjects who have a history of deep vein thrombosis (dvt) within the last 6 months * subjects who have an active leg ulcer (i.e. ceap classification of c6 1). * subjects with active cardiac disease or significant history of cardiac disease (including history of myocardial infarction, heart failure, valvular disease, arrhythmia and those with a pacemaker or have previously had a pacemaker). * subjects who have initiated treatment or changed the dose within the past month of pharmaceutical agents that reduce clotting e.g. aspirin (except low-dose aspirin), anti-platelets, anti-coagulants and coumarin. * subjects who are currently taking pharmaceutical agents that can modify the amount of leg oedema (e.g., diuretics, dihydropyridine calcium channel blockers, phlebotonic drugs, or fluctuating doses of systemic steroids) or have taken these agents within the last 10 days. * subjects who are pregnant * subjects who have worn compression therapy in the last 48 hours
standard vs targeted oxygen therapy prehospital for chronic obstructive pulmonary disease

Conditions: COPD Exacerbation; COPD Exacerbation Acute

Summary: the stop-copd trial is a randomized, patient-blinded, prehospital clinical trial designed to evaluate the effect of titrated oxygen therapy compared to standard oxygen treatment in patients with suspected acute exacerbation of chronic obstructive pulmonary disease (aecopd) treated with inhaled bronchodilators. the primary objective is to determine whether a titrated oxygen strategy targeting spo₂ 88-92% can reduce 30-day mortality compared to the current standard practice using 100% compressed oxygen as a nebulizer driver.

chronic obstructive pulmonary disease (copd) is a leading cause of morbidity and mortality globally. in the prehospital setting, patients with suspected acute exacerbation of copd (aecopd) are frequently treated with inhaled bronchodilators driven by 100% oxygen, despite concerns that high-concentration oxygen therapy may worsen hypercapnia and acidosis, leading to increased mortality. the stop-copd trial is a prospective, randomized, parallel-group, superiority trial conducted in the prehospital emergency medical services, central denmark region. patients aged 40 years or older with suspected aecopd requiring inhaled bronchodilators are randomized 1:1 to receive either: titrated oxygen therapy: inhaled bronchodilators driven by compressed air with supplemental oxygen titrated to maintain spo₂ 88-92%. standard treatment: inhaled bronchodilators driven by 100% compressed oxygen according to standard protocols. the primary outcome is 30-day all-cause mortality. secondary outcomes include 24-hour and 7-day mortality, need for invasive or non-invasive ventilation, development of respiratory acidosis upon hospital arrival, icu admission rate, length of hospital and icu stay, patient-experienced dyspnoea, and readmission rates. a total of 1,888 patients will be enrolled. the study is conducted under emergency research regulations allowing enrolment before informed consent, with consent obtained as soon as feasible after hospital admission. this trial seeks to evaluate whether titrating oxygen delivery in the prehospital phase can improve survival and clinical outcomes for patients with aecopd.

Eligibility criteria:
inclusion criteria: * patients over the age of 40 * emt or paramedic suspected aecopd * confirmed suspicion of copd exclusion criteria: * bronchospasm due to asthma, allergic reaction or non-copd conditions * known or suspected pregnancy * prehospital non-invasive, invasive or assisted bag mask ventilation * allergy to inhaled bronchodilators (salbutamol) * inter-hospital transfer * more than 2 doses (5 mg salbutamol) inhalation drug, acute treatment by ems (emergency medical service) personnel, before allocated treatment is initiated * suspicion of acute coronary syndrome

Keywords: titrated oxygen copd exacerbation prehospital copd
the single, multiple dose and food effect study of shr2285 tablets on pharmacokinetics and pharmacodynamics in healthy subjects

Conditions: Thrombosis

Summary: the study is a randomized, doubled-blinded, placebo-controlled, phase i trials. the study is divided into two parts. the first part is a single-dose escalated study (sad,part 1a ) and food effect study (sad, part 1b ) in healthy subjects. the second part is a multi-dose escalated study (mad) in healthy subjects.


Eligibility criteria:
inclusion criteria: 1. healthy subjects, aged 18-55 (including boundary); 2. body mass index (bmi) between 18 to 28 kg/m2 (including boundary), male body weight ≥50 kg and \<90 kg , female body weight ≥45kg and \<90kg; 3. participant with no clinically significant findings in vital signs, physical examination, 12-lead ecg ,x-ray and laboratory parameters. 4. understand the study procedures and methods, voluntary to participate in the study and signed the informed consent. exclusion criteria: 1. alanine aminotransferase (alt) or aspartate aminotransferase (ast) or total bilirubin/direct bilirubin \> upper limit of normal (uln) during screening/baseline. 2. serum creatinine\> uln during screening/baseline. 3. positive faecal occult blood 4. abnormal coagulation function. 5. a clinical history of coagulation dysfunction; subjects with adverse reaction of antiplatelet drugs or anticoagulant drugs. 6. subjects with severe head trauma or head surgery within 2 years or surgery within 3 months prior to the screening. 7. blood donation or blood loss within 1 month≥200 mlor≥400 ml within 3 months before administration. 8. human immunodeficiency virus antibody, syphilis serological examination, hepatitis b virus surface antigen, hepatitis c virus antibody were positive. 9.3 months prior to screening involved in any drug or medical device clinical studies or within 5 half-life of drugs before screening. 10.female subjects who did not receive contraception at least 30 days before administration and etc.
humanalbumin, hydroxyethylstarch and ringer lactate during cardiac surgery

Conditions: Valvular Heart Disease; Coronary Artery Disease

Summary: the aim of the study is to compare three different regimens for volume replacement during cardiac surgery, e.g. albumin 5%, hydroxyethylstarch 130/0.4 (hes) and ringer-lactate (rl). main outcome parameters: chest tube drainage and coagulation parameters. the investigators hypothesis is that hes is as safe as albumin, however less expensive. whether rl is an even less expensive and as safe alternative has to be shown.


Eligibility criteria:
inclusion criteria: * valve replacement * coronary bypass surgery exclusion criteria: * severe left ventricular dysfunction * coagulation disorders

Keywords: hydroxyethylstarch humanalbumin ringer lactate patients undergoing cardiac surgery
comparison of the impact of three programs of inspiratory muscles.

Conditions: Weaning From Mechanical Ventilation

Summary: ventilator-induced diaphragmatic dysfunction appears to contribute to slow weaning from mechanical ventilation. several trials of inspiratory muscle training to facilitate weaning in intensive care have been performed, with inconsistent results, utilizing different methods of imt in different populations. in this study, the investigators want to compare the incidence of 3 inspiratory muscle training programs on inspiratory strength, on difficult to wean patients in intensive care unit. this is a multi-center randomized trial not blinded with 3 parallels groups: * martin's group: a threshold-based imt is performed like used by martin in a randomized trial in 2011, in a view of inspiratory strength increase. * cader's group: a threshold-based imt is performed like used by cader in a randomized trial in 2010 , in a view of inspiratory endurance increase. * edric's group: a new treshold-based imt is performed, in a view of both inspiratory strength and endurance increase. the investigators think that a new threshold-based imt performed in a view of both inspiratory strength and endurance increase, is more effective and well tolerated than the 2 others protocols.

the main objective of this study is to determinate which imt program is the most effective on the inspiratory muscle strength and endurance increase. the investigators will be able to study the impact on the weaning time of imt performed with the best protocol. the investigators are going to conduct a randomized trial with intention-to-treat analysis. following 18h of invasive mechanical ventilation in a controlled mode, the failure of the first single breathe trial of 2 hours and the presence of sevrability criterias defined by the european consensus conference in 2007, 88 participants will be included. participants will be randomizesd to receive one of the 3 protocols of imt, 2 times per day, 7 days per week, from the inclusion to the extubation. the ratio of randomization will be 1:1:2 for a better evaluation of edric's group wich propose a new imt protocol.

Eligibility criteria:
inclusion criteria: * patient ventilated more than 18h in a controlled mode; * first single breathe trial of 2 hours failure; * presence of sevrability criterias definied by the european consensus conference in 2007 an usually used: * diminution of the sedfative agents, * patients with spontaneous beath in vac mode or patient ventilated in a vsai-pep mode, * pao2/fio2 ≥150, * absence d'inotropes ou de vasopresseurs à forte dose ou dose croissante (\<1mg/h), * sao2 \> 90% with fio2 ≤ 50%, * pep ≤ 8cmh2o, * corporal température between 36°c and 39°c, * glasgow score ≥ 8. exclusion criteria: * age \< 18 years ; * medically unstable; * poor vital pronostic at very short term; * cardiac arrest with a poor neurological prognostic; * neuromuscular disease ; * pneumothorax non drained ; * tracheostomy ; * current pregnancy ; * patients with guardianship or trusteeship.

Keywords: inspiratory muscles training programs ventilator-induced diaphragmatic dysfunction weaning intensive care unit
association of vitamin d, parathyroid hormone and fibroblast growth factor-23 with infarction-related arrhythmia in patients with acute myocardial infarction

Conditions: Acute Myocardial Infarction

Summary: to investigate the effect of vitamin d deficiency on the development of arrhythmia in patients with acute myocardial infarction.


Eligibility criteria:
inclusion criteria: * age ≥20 years * diagnosed with acute myocardial infarction (confirmed by cardiac enzyme and ekg) * subjects who agreed with informed consent exclusion criteria: * previous history of arrhythmia before onset of acute myocardial infarction * currently taking anti-arrhythmic drugs * severe condition of comorbid diseases that can cause more serious effects on patients than acute myocardial infarction does (e.g., cancer, cerebrovascular diseases, acute bleeding etc.)
safety and efficacy of adalimumab in patients with active ankylosing spondylitis

Conditions: Ankylosing Spondylitis

Summary: the purpose of the study is to assess the safety and clinical efficacy of adalimumab in subjects with active ankylosing spondylitis


Eligibility criteria:
inclusion criteria: * subject was age 18 or older and in relatively good health (investigator discretion) with a recent stable medical history. * subject met the definition of as based on the modified new york criteria. * subject had an inadequate response to or intolerance to one or more nsaids as defined by the investigator exclusion criteria: * subject had previously received anti-tnf therapy. * subject considered by the investigator, for any reason, to be an unsuitable candidate for the study * female subject who is pregnant or breast-feeding or considering becoming pregnant

Keywords: ankylosing spondylitis adalimumab
the clinical significance of the uncinate process histopathology in chronic rhinosinusitis

Conditions: Rhinosinusitis

Summary: given that the uncinate process is the gatekeeper of the sinuses, we hypothesize that inflammation of the uncinate process is associated with decreased ventilation and drainage of the paranasal sinuses and consequently with the inflammatory process occuring in the sinuses.

the purpose of the present study is to gain insight into the histopathological changes of the uncinate process in patients with chronic rhinosinusitis through comparison of its mucosal and bony elements with those of the normal uncinate process without chronic inflammation (unpublished data: gilead berger, ephraim eviatar, tatiana kogan, roee landsberg).

Eligibility criteria:
inclusion criteria: patients with chronic rhinosinusitis who: * failed conservative medical treatment. * stopped treatment (topical or systemic corticosteroids) at least two months before endoscopic sinus surgery. * had a lund-mackay ct score of 2 and higher of 24 available. exclusion criteria: * immunosuppressed patients. * patients in whom a pathologic evaluation of the middle turbinate was necessary (e.g., suspected neoplastic disorder). * patients with a lund-mackay ct score \< 2 of 24 available. * pregnant women. * patients who underwent prior endoscopic sinus surgery.

Keywords: chronic rhinosinusitis histopathology infundibulum lamina propria uncinate process
effect of a secure message reminder on hypertension follow-up at an integrated health care system

Conditions: Hypertension

Summary: this study will assess whether adding a secure message reminder to routine care improves the percentage of patients who complete a follow-up appointment with a new, documented blood pressure reading.

hypertension is one of the leading risk factors for cardiovascular disease. optimizing blood pressure management can help prevent adverse cardiovascular outcomes. the national committee for quality assurance (ncqa) defines blood pressure control as less than 140/90 mmhg. per this definition, less than half of americans with hypertension are considered controlled. literature has been published describing several ways of improving blood pressure management, but results have been variable.

Eligibility criteria:
inclusion criteria: * member of kaiser permanente georgia pharmacy cardiac risk service (pcrs) * 18-75 years of age * enrolled in http://kp.org * most recent documented blood pressure is greater than or equal to 140/90 mmhg exclusion criteria: * most recent documented blood pressure is greater than or equal to 180/110 mmhg

Keywords: hypertension